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Dept of Cardiology, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, UK.
Published: November 2020
AI Article Synopsis
Transcatheter aortic valve replacement (TAVR) is a recognized treatment for severe aortic stenosis and has recently been applied to treat failures of bioprosthetic surgical aortic valves (sAVR) through a technique known as valve-in-valve TAVR (ViV-TAVR).
Though data on ViV-TAVR primarily come from observational studies, initial findings suggest it offers similar outcomes to re-do sAVR in high-risk patients.
The case presented in this text highlights a rare situation of TAVR failure in a patient who had prior sAVR, necessitating an innovative procedure called valve-in-valve-in-valve TAVR (ViViV-TAVR).
Article Abstract
Transcatheter aortic valve replacement (TAVR) is a well-established treatment option for severe symptomatic aortic stenosis (Leon et al., 2016), and recently has also been utilised for bioprosthetic surgical aortic valve (sAVR) failure (valve-in-valve TAVR (ViV-TAVR)) (Yoon et al., 2017; Nalluri et al., 2018). Data supporting ViV-TAVR are limited to observational studies but suggest similar outcomes to re-do sAVR in high risk patients (Barbanti et al., n.d.). Whilst bioprosthetic SAVR failure is well documented, TAVR failure is less well described (Barbanti et al., n.d.). Here, we describe a case of TAVR failure in a previous sAVR resulting in the need for emergent valve-in-valve-in-valve TAVR (ViViV-TAVR).
